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Rostamzad P, Pleumeekers MM, Versnel SL, Loudon SE. Effect of Midface Surgery on Ocular Outcomes in Patients with Orbital and Midface Malformations. J Clin Med 2023; 12:jcm12113862. [PMID: 37298056 DOI: 10.3390/jcm12113862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: Orbital and midface malformations occur in multiple craniofacial disorders. Depending on the deformity, surgical corrections include orbital box osteotomy (OBO), Le Fort III (LFIII), monobloc (MB), and facial bipartition (FB). The aim of this study was to determine the effect of these procedures on ocular outcomes. (2) Methods: A retrospective analysis was performed. All patients with craniofacial disorders who had previously undergone midface surgery were included. The Wilcoxon signed ranks test was used for statistical analysis. (3) Results: In total, 63 patients were included: two patients were treated by OBO, 20 by LFIII, 26 by MB, and 15 by FB. Pre-operatively, strabismus was present in 39 patients (61.9%), in whom exotropia was most common (n = 27; 42.9%), followed by esotropia (n = 11; 17.5%). Postoperatively, strabismus significantly worsened (p = 0.035) in the overall population (n = 63). Pre-operative binocular vision (n = 33) was absent in nine patients (27.3%), poor in eight (24.2%), moderate in 15 (45.5%), and good in one (3.0%). Postoperatively, binocular vision significantly improved (p < 0.001). Before surgery, the mean visual acuity (VA) in the better eye was 0.16 LogMAR (Logarithm of the Minimum Angle of Resolution), and 0.31 LogMAR in the worse eye. Furthermore, pre-operative astigmatism was present in 46 patients (73.0%) and hypermetropia in 37 patients (58.7%). No statistical difference was found for VA (n = 51; p = 0.058) postoperatively. (4) Conclusions: Midface surgery has a direct and indirect substantial effect on several ocular outcomes. This study emphasizes the importance of appropriate ophthalmological evaluation in patients with craniofacial disorders undergoing midface surgery.
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Affiliation(s)
- Parinaz Rostamzad
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Mieke M Pleumeekers
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Sarah L Versnel
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Sjoukje E Loudon
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
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2
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Vagha J, Wazurkar A, Vagha K, Lohiya S, Varma A. A Rare Case of Telecanthus-Hypospadias Syndrome in a Pediatric Patient. Cureus 2023; 15:e37411. [PMID: 37181966 PMCID: PMC10174682 DOI: 10.7759/cureus.37411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Hypertelorism and hypospadias are the main characteristics of telecanthus-hypospadias syndrome; however, it can also include other midline structural anomalies, such as cleft lip and palate, cryptorchidism, congenital heart problem, laryngotracheal cleft, esophageal fistula, and irregular scrotum. Here, we describe an eight-year-old male who was brought to us for cleft lip repair, but upon evaluation, the other listed anomalies were discovered. He had hypertelorism, hypospadias, a ventricular septal defect, and a history of cryptorchidism. A multidisciplinary approach involved pediatricians, oral surgeons, cardiologists, and pediatric surgeons. The patient underwent surgery for first-stage hypospadias correction and was advised to follow up for additional surgery and maintenance procedures before being discharged. We wish to report this case with the aim to enlighten budding pediatricians and surgeons about this rare syndrome.
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Affiliation(s)
- Jayant Vagha
- Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ajinkya Wazurkar
- Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Keta Vagha
- Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sham Lohiya
- Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ashish Varma
- Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Ahmed F, Altam A, Alyhari Q, Badheeb M, Aljbri W, Al-wageeh S, Al-Naggar A, Ghabisha S, Al-Shami E. Surgical management of penoscrotal hypospadias in a child with Opitz G/BBB syndrome: a case report. Pan Afr Med J 2023; 44:103. [PMID: 37250678 PMCID: PMC10219829 DOI: 10.11604/pamj.2023.44.103.38737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/02/2023] [Indexed: 05/31/2023] Open
Abstract
Opitz G/BBB syndrome is a rare condition characterized by three significant anomalies; hypertelorism, cleft lip and palate, and hypospadias. However, other anomalies may be associated. Herein, we report a 4-year-old child presented with penoscrotal hypospadias. On examination, hypertelorism and cleft lip and palate were noticed, suggesting a diagnosis of Opitz G/BBB syndrome. The cleft lip was corrected in the first year, and a two-staged surgical approach was implemented for penoscrotal hypospadias. In the first stage, the chordee was corrected and urethral plate was reconstructed using a tabularized incised plate urethroplasty and testicular tunica vaginalis flap. In the second stage, the remanent hypospadias was corrected, and the meatal opening reached its normal location. In conclusion, a two-staged surgical approach for the treatment of penoscrotal hypospadias associated with Opitz G/BBB syndrome may provide excellent outcomes in early-recognized cases. The urologist should pay attention to abnormal facial characteristics in patients with hypospadias.
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Affiliation(s)
- Faisal Ahmed
- Department of Urology, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Abdulfattah Altam
- Department of General Surgery, School of Medicine, 21 September University, Sana'a, Yemen
| | - Qasem Alyhari
- Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Mohamed Badheeb
- Department of Internal Medicine, College of Medicine, Hadhramaut University, Mukalla, Yemen
| | - Waleed Aljbri
- Department of Urology, School of Medicine, 21 September University, Sana'a, Yemen
| | - Saleh Al-wageeh
- Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Abdullah Al-Naggar
- Department of Anesthesiology, Al-Thora Modern Hospital, Faculty of Medicine, Sana´a University of Medical Sciences, Sana´a, Yemen
| | - Saif Ghabisha
- Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
| | - Ebrahim Al-Shami
- Department of Urology, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
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4
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Pachajoa H, Vasquez-Forero DM, Giraldo-Ocampo S. Case report: Craniofrontonasal syndrome caused by a novel variant in the EFNB1 gene in a Colombian woman. Front Genet 2023; 13:1092301. [PMID: 36685875 PMCID: PMC9845254 DOI: 10.3389/fgene.2022.1092301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/30/2022] [Indexed: 01/05/2023] Open
Abstract
Craniofrontonasal Syndrome is a very rare dominant X-linked genetic disorder characterized by symptoms such as hypertelorism, craniosynostosis, eye alterations, bifid nose tip, and longitudinal ridging and splitting of nails. Heterozygous females are usually the patients severely affected. To date, clinical or genetic data have not been published for these patients in Colombia. Here we report a female proband with coronal craniosynostosis, hypertelorism, strabismus, rotational nystagmus, high-arched palate, dental crowding, scoliosis, severe pectus excavatum, unilateral breast hypoplasia, and brachydactyly; diagnosed with Craniofrontonasal Syndrome with the novel heterozygous variant c.374A>C (p.Glu125Ala) in the EFNB1 gene. So far, she has been treated with physical therapy and surgical correction of the bifid nose and an umbilical hernia. To the best of our knowledge, this is the first report of a patient with this rare genetic disorder in Colombia, expanding its mutational spectrum and highlighting the importance of genetic evaluation of patients with craniosynostosis and facial dysmorphism.
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Affiliation(s)
- Harry Pachajoa
- Genetics Division, Fundación Valle del Lili, Cali, Colombia,Centro de Investigaciones en Anomalías Congénitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia,*Correspondence: Harry Pachajoa,
| | - Diana Marcela Vasquez-Forero
- Genetics Division, Fundación Valle del Lili, Cali, Colombia,Centro de Investigaciones en Anomalías Congénitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
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Mark PR, Murray SA, Yang T, Eby A, Lai A, Lu D, Zieba J, Rajasekaran S, VanSickle EA, Rossetti LZ, Guidugli L, Watkins K, Wright MS, Bupp CP, Prokop JW. Autosomal recessive LRP1-related syndrome featuring cardiopulmonary dysfunction, bone dysmorphology, and corneal clouding. Cold Spring Harb Mol Case Stud 2022; 8:mcs.a006169. [PMID: 36307211 PMCID: PMC9632358 DOI: 10.1101/mcs.a006169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 08/22/2022] [Indexed: 01/25/2023] Open
Abstract
We provide the first study of two siblings with a novel autosomal recessive LRP1-related syndrome identified by rapid genome sequencing and overlapping multiple genetic models. The patients presented with respiratory distress, congenital heart defects, hypotonia, dysmorphology, and unique findings, including corneal clouding and ascites. Both siblings had compound heterozygous damaging variants, c.11420G > C (p.Cys3807Ser) and c.12407T > G (p.Val4136Gly) in LRP1, in which segregation analysis helped dismiss additional variants of interest. LRP1 analysis using multiple human/mouse data sets reveals a correlation to patient phenotypes of Peters plus syndrome with additional severe cardiomyopathy and blood vessel development complications linked to neural crest cells.
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Affiliation(s)
- Paul R. Mark
- Division of Medical Genetics, Spectrum Health, Grand Rapids, Michigan 49503, USA;,Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, Michigan 49503, USA
| | | | - Tao Yang
- Department of Cell Biology, Van Andel Institute, Grand Rapids, Michigan 49503, USA
| | - Alexandra Eby
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, Michigan 49503, USA;,Department of Science, Davenport University, Grand Rapids, Michigan 49512, USA
| | - Angela Lai
- Neonatal Intensive Care Unit, Bronson Methodist Hospital, Kalamazoo, Michigan 49007, USA
| | - Di Lu
- Department of Cell Biology, Van Andel Institute, Grand Rapids, Michigan 49503, USA
| | - Jacob Zieba
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, Michigan 49503, USA;,Genetics and Genome Sciences Program, Michigan State University, East Lansing, Michigan 48824, USA
| | - Surender Rajasekaran
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, Michigan 49503, USA;,Office of Research, Spectrum Health, Grand Rapids, Michigan 49503, USA
| | | | - Linda Z. Rossetti
- Division of Medical Genetics, Spectrum Health, Grand Rapids, Michigan 49503, USA;,Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, Michigan 49503, USA
| | - Lucia Guidugli
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Kelly Watkins
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Meredith S. Wright
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Caleb P. Bupp
- Division of Medical Genetics, Spectrum Health, Grand Rapids, Michigan 49503, USA;,Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, Michigan 49503, USA
| | - Jeremy W. Prokop
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, Michigan 49503, USA;,Genetics and Genome Sciences Program, Michigan State University, East Lansing, Michigan 48824, USA;,Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan 48824, USA
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6
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Mooss VS, Kavitha V, Ravishankar HN, Heralgi MM, Aafreen S. Presence and development of strabismus in children with telecanthus, epicanthus and hypertelorism. Indian J Ophthalmol 2022; 70:3618-3624. [PMID: 36190058 PMCID: PMC9789851 DOI: 10.4103/ijo.ijo_776_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To study the presence and development of strabismus in children with telecanthus, epicanthus, and hypertelorism. Methods This is a prospective, longitudinal, and observational study. Sixty children aged between 6 months and 18 years with telecanthus, epicanthus, and hypertelorism in isolation or in combination were recruited. A detailed analysis of the history, determination of best corrected visual acuity, complete evaluation of strabismus, and ocular examination were carried out. The presence of telecanthus, epicanthus, and hypertelorism and associated strabismus, if any, was noted. All children were followed up for a minimum and maximum period of 12 and 18 months, respectively, to analyze the strabismus (previously present) and for detection of strabismus in those who did not have. The data were analyzed descriptively with mean and standard deviation. Chi square test and Fishers exact test were used to analyze the data between the groups. A P value less than 0.05 was considered to be statistically significant. Results Telecanthus was the most common lid feature (55%). At baseline, ten (16.66%) children had strabismus (six: esotropia; four: exotropia). Two (3.33%) children underwent surgery. One child developed exotropia at the third follow-up (18 months). At the end of the study, 11 (18.33%) children had strabismus. No significant association was seen between lid characteristics and the type of strabismus. Conclusion Children with telecanthus, epicanthus, and hypertelorism in isolation or in combination may or may not have associated strabismus. These features can pose difficulty in strabismus diagnosis, which mandates a careful examination, especially in younger age groups and small-angle strabismus. On the other hand, children without strabismus need longer follow-up to detect the development of strabismus and to initiate further management at the earliest.
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Affiliation(s)
- Vidya S Mooss
- Department of General Ophthalmology, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
| | - V Kavitha
- Department of Pediatric Ophthalmology, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India,Correspondence to: Dr. Kavitha V, Consultant, Department of Paediatric Ophthalmology, Sankara Eye Hospital, Harakere, Shimoga – 577 202, Karnataka, India. E-mail:
| | - H N Ravishankar
- Department of Vitreoretina, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
| | - Mallikarjun M Heralgi
- Department of Cornea Refractive Services, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
| | - Saba Aafreen
- Department of General Ophthalmology, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, India
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7
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Verma PK, Bhat NK. Oro-Facial-Digital Syndrome: Unspecified Type with the Spontaneous Fusion of Cleft Palate. Contemp Clin Dent 2021; 12:454-458. [PMID: 35068850 PMCID: PMC8740786 DOI: 10.4103/ccd.ccd_754_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/31/2020] [Accepted: 02/17/2021] [Indexed: 11/20/2022] Open
Abstract
Oro-facial-digital syndrome (OFD) is a disorder with varied inheritance patterns. They deal mainly with abnormalities of the face, digits, i.e., fingers and toes, and oral cavity. Hypoplasia of nasal alar cartilage, broad nasal bridge, frontal bossing, and micrognathia are the common facial abnormalities observed in its multiple potential forms. Among the oral features, lobulated tongue, multiple frenulae, and cleft lip/palate are the common findings. The subject presented in our case manifested cleft of the hard palate at the time of presentation, along with other diverse features, which could not match any of the defined OFD types in literature. Furthermore, follow-up of the infant observed closure of the palate spontaneously, without any intervention. Hence, the purpose is to add to the knowledge the typical features of this unspecified type of OFD, along with this unique unprompted cleft palate closure, which aroused the need of close watch in such cases.
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Affiliation(s)
- Prashant Kumar Verma
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nowneet Kumar Bhat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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8
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Balaji SM, Ganesh CVS, Balaji P. Management of Large Dural Defect with CSF Leak in Hypertelorism Correction. Ann Maxillofac Surg 2021; 11:136-139. [PMID: 34522669 PMCID: PMC8407622 DOI: 10.4103/ams.ams_43_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/26/2021] [Indexed: 11/04/2022] Open
Abstract
The Rationale Dural tear is a serious complication during hypertelorism corrective surgeries. Identifying the tear and managing requires considerable expertise. Managing large dural tears correctly is necessary to prevent cerebrospinal fluid (CSF)-related complications in craniofacial surgery. Patient Concerns The patient presented with hypertelorism as a part of the Tessier Cleft 0 and sought to correct the widely placed eyes. Diagnosis Large critical-sized dural tear during modified box osteotomy surgery. Treatment Besides successful modified box osteotomy surgery, the critical-sized dural tear was managed with fascia lata and fibrin glue. Outcomes There was no CSF leak or related complication postsurgically indicating successful sealing and healing of the dural tear. Take-Away Lessons The synergistic mechanism by which fascia lata graft and fibrin glue help to hermetically seal the critical-sized defect, especially when there are variable amounts of hydrostatic-hydrodynamic forces of CSF exerting pressure on the patched area, is discussed.
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Affiliation(s)
- S M Balaji
- Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India
| | - C V Shankar Ganesh
- Department of Neurosurgery, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India
| | - Preetha Balaji
- Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India
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Vargel I, Canter HI, Kucukguven A, Aydin A, Ozgur F. ALX-Related Frontonasal Dysplasias: Clinical Characteristics and Surgical Management. Cleft Palate Craniofac J 2021; 59:637-643. [PMID: 34098755 DOI: 10.1177/10556656211019621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIM The term frontonasal dysplasia (FND) represents a spectrum of anomalies and its genetics have not been well defined. Recently, the critical role of the aristaless-like homeobox (ALX) gene family on the craniofacial development has been discovered. In the present study, we aimed to propose a systematic surgical treatment plan for the ALX-related FNDs according to the genotypic classification as well as demonstrating their clinical characteristics to help surgeons diagnose the underlying pathology accurately. DESIGN Single-institution retrospective. SETTING Tertiary health care. PATIENTS AND METHODS Eighty-nine FND cases were evaluated. Eight of them had ALX1-related FND3, 3 had ALX3-related FND1, and 2 had ALX4-related FND2. Phenotype characteristics of ALX-related FNDs were evaluated, and relevant surgical interventions were assessed. RESULTS The ALX1-related FND3 phenotype is striking due to the involvement of the eyes in addition to the presence of hypertelorism, facial clefts, and nasal deformities. A widened philtrum and prominent philtral columns are remarkable features of the ALX3-related FND1, whereas the ALX4-related FND2 has more severe deformities: severe hypertelorism, brachycephaly, large parietal bone defects, broad nasal dorsum, and alopecia. Facial bipartition, box osteotomies, eyelid coloboma repair, cleft lip and palate repair, nasal reconstruction, and fronto-orbital advancement can be performed in ALX-related FNDs based on the characteristics of each subtype. CONCLUSIONS This genetic classification system will help surgeon diagnose patients with FND with unique features and draw a roadmap for their treatment with a better surgical perspective.
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Affiliation(s)
- Ibrahim Vargel
- 37515Hacettepe University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Turkey
| | - Halil Ibrahim Canter
- 356435Anadolu Medical Center, Department of Plastic and Reconstructive Surgery, Istanbul, Turkey
| | - Arda Kucukguven
- 37515Hacettepe University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Turkey
| | - Asim Aydin
- 52994Suleyman Demirel University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Isparta, Turkey
| | - Figen Ozgur
- 37515Hacettepe University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Turkey
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Khelkar PC, Kadam AN, Karjodkar FR, Sansare KP. Apert's syndrome: A rare craniofacial disorder. J Indian Soc Pedod Prev Dent 2020; 38:430-433. [PMID: 33402629 DOI: 10.4103/jisppd.jisppd_434_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Apert's syndrome (AS) which is a rare congenital disorder is a form of acrocephalosyndactyly. This syndrome is characterized by craniosynostosis, midface hypoplasia, and syndactyly of hands and feet. We report a case of 13-year-old boy in India presenting features of AS such as exophthalmos, hypertelorism, strabismus, steep forehead, parrot beak nose, depressed nasal bridge, and retruded middle third of the face. The purpose of this report is to present a case of AS by highlighting the craniofacial characteristics.
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Affiliation(s)
- Prajakta C Khelkar
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Aaditi N Kadam
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Freny R Karjodkar
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Kaustubh P Sansare
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
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11
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Unni JV, Daryani D, Sreejan KC, Uthkal PM. Greig Cephalopolysyndactyly Syndrome with Oral Manifestations: A Rare Case Report. Int J Appl Basic Med Res 2020; 10:140-142. [PMID: 32566533 PMCID: PMC7289203 DOI: 10.4103/ijabmr.ijabmr_391_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 04/01/2019] [Accepted: 01/24/2020] [Indexed: 11/06/2022] Open
Abstract
Greig cephalopolysyndactyly syndrome (GCPS) is one of the autosomal dominant-inherited syndromes, caused by haploinsufficiency of the GLI3 gene. It is a rare, multiple congenital syndrome with an estimated rate of 0.009%. With the classic clinical triad of preaxial polydactyly with cutaneous syndactyly of at least one limb, hypertelorism, and macrocephaly, presumptive diagnosis of GCPS is made. The purpose of this article is to report a case of GCPS with emphasis on craniofacial and oral features.
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Affiliation(s)
- Jiji V Unni
- Department of Oral Medicine and Radiology, Malabar Dental College and Research Centre, Edappal, Kerala, India
| | - Deepak Daryani
- Department of Oral Medicine and Radiology, Malabar Dental College and Research Centre, Edappal, Kerala, India
| | - K C Sreejan
- Department of Oral Medicine and Radiology, Malabar Dental College and Research Centre, Edappal, Kerala, India
| | - P M Uthkal
- Department of Oral Medicine and Radiology, Malabar Dental College and Research Centre, Edappal, Kerala, India
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12
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Garcia-Rodriguez R, Rodriguez-Rodriguez R, Garcia-Delgado R, Romero-Requejo A, Medina-Castellano M, Garcia Cruz L, Santana Rodriguez A, Garcia-Hernandez JA. Prenatal diagnosis of Greig Cephalopolysyndactyly Syndrome. When to suspect it. J Matern Fetal Neonatal Med 2020; 35:2162-2165. [PMID: 32495660 DOI: 10.1080/14767058.2020.1774541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Greig Cephalopolysyndactyly Syndrome (GCPS) is a very rare multiple congenital anomaly with an estimated incidence of 1-9:1,000,000 in newborns with principal findings of macrocephaly, ocular hypertelorism, and polysyndactyly (preaxial or mixed preaxial and postaxial). Very few cases of prenatal diagnoses have been reported. The postnatal diagnosis is based on clinical findings and family background. GLI3, the only gene associated with this anomaly, is altered in more than 75% of cases. Deletions over 1 Mb and involving other genes yield severe clinical cases, which are known collectively as Greig Cephalopolysyndactyly-contiguous gene Syndrome. We report a case in which, despite early polydactyly findings on week 16, the diagnosis was established during the third trimester of pregnancy due to the late presentation of other anomalies corresponding to this syndrome.
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Affiliation(s)
- Raquel Garcia-Rodriguez
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Raul Rodriguez-Rodriguez
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Raquel Garcia-Delgado
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Azahar Romero-Requejo
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Margarita Medina-Castellano
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Loida Garcia Cruz
- Clinical Genetics Unit, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Alfredo Santana Rodriguez
- Clinical Genetics Unit, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Jose Angel Garcia-Hernandez
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
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13
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Abstract
Background: Schizencephaly is a rare defect which is identified as clefts that are lined with grey matter extending from the ependyma of the cerebral ventricles to the pia mater. An encephalocele occurs due to failure of neural tube closure resulting in a gap through which cerebrospinal fluid and meninges can bulge into a pouch. There have been rare instances when these two defects have presented simultaneously. Case Description: We report a case of a 17-year-old child who was brought by his parents with complaint of swelling over his nose and forehead and aggressive behavior since birth. Magnetic resonance imaging findings were consistent with frontoethmoidal meningoencephalocele with schizencephaly. Lumbar drain was inserted and kept in place for 1 week followed by surgical correction of the defect. Our case is interesting because of delayed presentation as it is a rare entity and its association with schizencephaly. Conclusion: Encephalocele association with schizencephaly is rare.
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Affiliation(s)
- Asra Tanwir
- Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Sarmad Bukhari
- Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
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14
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Koboldt DC, Mihalic Mosher T, Kelly BJ, Sites E, Bartholomew D, Hickey SE, McBride K, Wilson RK, White P. A de novo nonsense mutation in ASXL3 shared by siblings with Bainbridge-Ropers syndrome. Cold Spring Harb Mol Case Stud 2018; 4:mcs.a002410. [PMID: 29305346 PMCID: PMC5983172 DOI: 10.1101/mcs.a002410] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/26/2017] [Indexed: 12/31/2022] Open
Abstract
Two sisters (ages 16 yr and 15 yr) have been followed by our clinical genetics team for several years. Both girls have severe intellectual disability, hypotonia, seizures, and distinctive craniofacial features. The parents are healthy and have no other children. Oligo array, fragile X testing, and numerous single-gene tests were negative. All four family members underwent research exome sequencing, which revealed a heterozygous nonsense mutation in ASXL3 (p.R1036X) that segregated with disease. Exome data and independent Sanger sequencing confirmed that the variant is de novo, suggesting possible germline mosaicism in one parent. The p.R1036X variant has never been observed in healthy human populations and has been previously reported as a pathogenic mutation. Truncating de novo mutations in ASXL3 cause Bainbridge–Ropers syndrome (BRPS), a developmental disorder with similarities to Bohring–Opitz syndrome. Fewer than 30 BRPS patients have been described in the literature; to our knowledge, this is the first report of the disorder in two related individuals. Our findings lend further support to intellectual disability, absent speech, autistic traits, hypotonia, and distinctive facial appearance as common emerging features of Bainbridge–Ropers syndrome.
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Affiliation(s)
- Daniel C Koboldt
- Institute for Genomic Medicine at Nationwide Children's Hospital, Columbus, Ohio 43205, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio 43205, USA
| | - Theresa Mihalic Mosher
- Institute for Genomic Medicine at Nationwide Children's Hospital, Columbus, Ohio 43205, USA.,Division of Molecular and Human Genetics, Nationwide Children's Hospital, Columbus, Ohio 43205, USA
| | - Benjamin J Kelly
- Institute for Genomic Medicine at Nationwide Children's Hospital, Columbus, Ohio 43205, USA
| | - Emily Sites
- Division of Molecular and Human Genetics, Nationwide Children's Hospital, Columbus, Ohio 43205, USA
| | - Dennis Bartholomew
- Department of Pediatrics, The Ohio State University, Columbus, Ohio 43205, USA.,Division of Molecular and Human Genetics, Nationwide Children's Hospital, Columbus, Ohio 43205, USA
| | - Scott E Hickey
- Department of Pediatrics, The Ohio State University, Columbus, Ohio 43205, USA.,Division of Molecular and Human Genetics, Nationwide Children's Hospital, Columbus, Ohio 43205, USA
| | - Kim McBride
- Department of Pediatrics, The Ohio State University, Columbus, Ohio 43205, USA.,Division of Molecular and Human Genetics, Nationwide Children's Hospital, Columbus, Ohio 43205, USA.,Center for Cardiovascular and Pulmonary Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio 43205, USA
| | - Richard K Wilson
- Institute for Genomic Medicine at Nationwide Children's Hospital, Columbus, Ohio 43205, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio 43205, USA
| | - Peter White
- Institute for Genomic Medicine at Nationwide Children's Hospital, Columbus, Ohio 43205, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio 43205, USA
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15
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Johnston JJ, Lee C, Wentzensen IM, Parisi MA, Crenshaw MM, Sapp JC, Gross JM, Wallingford JB, Biesecker LG. Compound heterozygous alterations in intraflagellar transport protein CLUAP1 in a child with a novel Joubert and oral-facial-digital overlap syndrome. Cold Spring Harb Mol Case Stud 2017; 3:mcs.a001321. [PMID: 28679688 PMCID: PMC5495032 DOI: 10.1101/mcs.a001321] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 10/05/2016] [Indexed: 12/17/2022] Open
Abstract
Disruption of normal ciliary function results in a range of diseases collectively referred to as ciliopathies. Here we report a child with a phenotype that overlapped with Joubert, oral–facial–digital, and Pallister–Hall syndromes including brain, limb, and craniofacial anomalies. We performed exome-sequence analysis on a proband and both parents, filtered for putative causative variants, and Sanger-verified variants of interest. Identified variants in CLUAP1 were functionally analyzed in a Xenopus system to determine their effect on ciliary function. Two variants in CLUAP1 were identified through exome-sequence analysis, Chr16:g.3558407T>G, c.338T>G, p.(Met113Arg) and Chr16:g.3570011C>T, c.688C>T, p.(Arg230Ter). These variants were rare in the Exome Aggregation Consortium (ExAC) data set of 65,000 individuals (one and two occurrences, respectively). Transfection of mutant CLUAP1 constructs into Xenopus embryos showed reduced protein levels p.(Arg230Ter) and reduced intraflagellar transport p.(Met113Arg). The genetic data show that these variants are present in an affected child, are rare in the population, and result in reduced, but not absent, intraflagellar transport. We conclude that biallelic mutations in CLUAP1 resulted in this novel ciliopathy syndrome in the proband.
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Affiliation(s)
- Jennifer J Johnston
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892-4472, USA
| | - Chanjae Lee
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas 78705, USA
| | - Ingrid M Wentzensen
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892-4472, USA
| | - Melissa A Parisi
- Intellectual and Developmental Disabilities Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Molly M Crenshaw
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892-4472, USA
| | - Julie C Sapp
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892-4472, USA
| | - Jeffrey M Gross
- Departments of Ophthalmology and Developmental Biology, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - John B Wallingford
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas 78705, USA
| | - Leslie G Biesecker
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892-4472, USA
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16
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Jeppesen BF, Hove HB, Kreiborg S, Hermann NV, Darvann TA, Jørgensen FS. Prenatal diagnosis of autosomal recessive Robinow syndrome using 3D ultrasound. Clin Case Rep 2017; 5:1072-1076. [PMID: 28680597 PMCID: PMC5494388 DOI: 10.1002/ccr3.784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/11/2016] [Accepted: 10/25/2016] [Indexed: 11/06/2022] Open
Abstract
This article hypothesizes that it is possible to detect and diagnose both the autosomal recessive and dominant forms prenatally using ultrasound. By focusing on the characteristic phenotypical presentation, the examinator is able to diagnose the syndrome prenatally, which is of clinical importance to the parents and counseling for the consideration of terminating the pregnancy.
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Affiliation(s)
- Bolette F Jeppesen
- Department of Clinical Genetics Copenhagen University Hospital Rigshospitalet Copenhagen Denmark.,Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Hanne B Hove
- Department of Clinical Genetics Copenhagen University Hospital Rigshospitalet Copenhagen Denmark.,Department of Clinical Genetics The RAREDIS Database Section of Rare Diseases Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Sven Kreiborg
- Department of Pediatric Dentistry and Clinical Genetics School of Dentistr yFaculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark.,3D Craniofacial Image Research Laboratory (School of Dentistry, University of Copenhagen; Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet; and Department of Applied Mathematics and Computer Science, Technical University of Denmark) Copenhagen Denmark
| | - Nuno V Hermann
- Department of Pediatric Dentistry and Clinical Genetics School of Dentistr yFaculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark.,3D Craniofacial Image Research Laboratory (School of Dentistry, University of Copenhagen; Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet; and Department of Applied Mathematics and Computer Science, Technical University of Denmark) Copenhagen Denmark
| | - Tron A Darvann
- 3D Craniofacial Image Research Laboratory (School of Dentistry, University of Copenhagen; Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet; and Department of Applied Mathematics and Computer Science, Technical University of Denmark) Copenhagen Denmark.,Department of Oral and Maxillofacial Surgery Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Finn Stener Jørgensen
- Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark.,Fetal Medicine Unit Department of Obstetrics and Gynecology Copenhagen University Hospital Hvidovre Hvidovre Denmark
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17
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Laccetta G, Moscuzza F, Michelucci A, Guzzetta A, Lunardi S, Lorenzoni F, Ghirri P. A Novel Missense Mutation of the NSD1 Gene Associated with Overgrowth in Three Generations of an Italian Family: Case Report, Differential Diagnosis, and Review of Mutations of NSD1 Gene in Familial Sotos Syndrome. Front Pediatr 2017; 5:236. [PMID: 29164086 PMCID: PMC5681921 DOI: 10.3389/fped.2017.00236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/19/2017] [Indexed: 12/31/2022] Open
Abstract
Sotos syndrome (SoS) is characterized by overgrowth of prenatal onset, learning disability, and characteristic facial appearance; it is usually due to haploinsufficiency of NSD1 gene at chromosome 5q35. An Italian child was born at 37 weeks of gestation (weight 2,910 g, 25th-50th centiles; length 50 cm, 75th centile; head circumference 36 cm, 97th centile) showing cryptorchidism on the right side, hypertelorism, dolichocephaly, broad and prominent forehead, and narrow jaw; the pregnancy was worsened by maternal preeclampsia and gestational diabetes, and his mother had a previous history of four early miscarriages. The patient showed neonatal jaundice, hypotonia, feeding difficulties, frequent vomiting, and gastroesophageal reflux. After the age of 6 months, his weight, length, and head circumference were above the 97th centile; psychomotor development was delayed. At the age of 9 years, the patient showed also joint laxity and scoliosis. DNA sequence analysis of NSD1 gene detected a novel heterozygous mutation (c.521T>A, p.Val174Asp) in exon 2. The same mutant allele was also found in the mother and in the maternal grandfather of the proband; both the mother and the maternal grandfather of the proband showed isolated overgrowth with height above the 97th centile in absence of other features of SoS. At present 23 familial cases of SoS have been described (two cases with mutation in exon 2 of NSD1 gene); no familial cases of SoS with mutation of NSD1 gene and isolated overgrowth have been reported. Probably, point mutations of NSD1 gene, and particularly mutations between exon 20 and exon 23, are not likely to affect reproductive fitness. Epigenetic mechanisms and intrauterine environment may influence phenotypes, therefore genetic tests are not useful to predict the phenotype but they are indispensable for the diagnosis of SoS. This is the first Italian familial case of SoS with genetic confirmation and the third report in which a missense mutation of NSD1 gene is found in three generations of the same family.
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Affiliation(s)
- Gianluigi Laccetta
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care Unit, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Francesca Moscuzza
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care Unit, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Angela Michelucci
- Division of Cytogenetic and Molecular Biology, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Stella Maris, University of Pisa, Pisa, Italy
| | - Sara Lunardi
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care Unit, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Francesca Lorenzoni
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care Unit, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Paolo Ghirri
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care Unit, Santa Chiara Hospital, University of Pisa, Pisa, Italy
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18
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Cançado FHDSQ, da Silva LCP, Taitson PF, de Andrade ACDV, Pithon MM, Oliveira DD. Do you know this syndrome? Leopard syndrome. An Bras Dermatol 2017; 92:127-129. [PMID: 28225973 PMCID: PMC5312195 DOI: 10.1590/abd1806-4841.20174505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/20/2015] [Indexed: 11/22/2022] Open
Abstract
Hypertrophic cardiomyopathy is known as Leopard syndrome, which is a mnemonic rule for multiple lentigines (L), electrocardiographic conduction abnormalities (E), ocular hypertelorism (O), pulmonary stenosis (P), abnormalities of genitalia (A), retardation of growth (R), and deafness (D). We report the case of a 12-year-old patient with some of the abovementioned characteristics: hypertelorism, macroglossia, lentigines, hypospadias, cryptorchidism, subaortic stenosis, growth retardation, and hearing impairment. Due to this set of symptoms, we diagnosed Leopard syndrome.
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Affiliation(s)
| | - Luis Candido Pinto da Silva
- Odontology Department of the Pontifícia
Universidade Católica de Minas Gerais (PUC Minas) - Belo Horizonte (MG),
Brazil
| | - Paulo Franco Taitson
- Odontology Department of the Pontifícia
Universidade Católica de Minas Gerais (PUC Minas) - Belo Horizonte (MG),
Brazil
| | | | - Matheus Melo Pithon
- Health Department I of the Universidade Estadual do
Sudoeste da Bahia (UESB) - Itapetinga (BA), Brazil
| | - Dauro Douglas Oliveira
- Odontology Department of the Pontifícia
Universidade Católica de Minas Gerais (PUC Minas) - Belo Horizonte (MG),
Brazil
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19
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Raja JV, Asha ML, Kumar GA, Sattigeri AV, Malhotra D. Craniofacial ciliopathies: An expanding oral disease spectrum - a review of literature and a case report. Indian J Dent 2016; 7:153-157. [PMID: 27795653 PMCID: PMC5015569 DOI: 10.4103/0975-962x.180315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
For all intents and purposes, craniofacial development is initiated as soon as the anteroposterior axis of an embryo is established. Although the neural crest receives a significant amount of attention, craniofacial tissue has more patterning information than other tissues of the body. New studies have further clarifi ed the contribution of ciliary epithelia as a source of patterning information for the face. In this paper, we review the craniofacial anomalies in patients with ciliopathies, in which orofacial region is a pivotal recognition of the disorder. Also, a case report of a patient with suspected ciliopathy has been presented along with a logical approach for diagnosis of such disorders.
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Affiliation(s)
- Jigna V Raja
- Department of Oral Medicine and Radiology, Dr. Syamala Reddy Dental College Hospital and Research Center, Bengaluru, Karnataka, India
| | - M L Asha
- Department of Oral Medicine and Radiology, Dr. Syamala Reddy Dental College Hospital and Research Center, Bengaluru, Karnataka, India
| | - G Arun Kumar
- Department of Oral Medicine and Radiology, Dr. Syamala Reddy Dental College Hospital and Research Center, Bengaluru, Karnataka, India
| | - Anupama V Sattigeri
- Department of Oral Medicine and Radiology, Dr. Syamala Reddy Dental College Hospital and Research Center, Bengaluru, Karnataka, India
| | - Diksha Malhotra
- Department of Oral Medicine and Radiology, Dr. Syamala Reddy Dental College Hospital and Research Center, Bengaluru, Karnataka, India
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20
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Weinberg SM, Leslie EJ, Hecht JT, Wehby GL, Deleyiannis FWB, Moreno LM, Christensen K, Marazita ML. Hypertelorism and Orofacial Clefting Revisited: An Anthropometric Investigation. Cleft Palate Craniofac J 2016; 54:631-638. [PMID: 27505181 DOI: 10.1597/15-256] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Since the 1960s, multiple studies have reported a tendency toward hypertelorism in individuals with nonsyndromic orofacial clefts (OFCs). However, the association between specific cleft types and increased interorbital distance has been inconsistent. Using three-dimensional (3D) surface imaging, we tested whether different forms of clefting showed evidence of increased interorbital distance. METHODS Intercanthal and outercanthal distances and intercanthal indices were calculated from 3D facial surface images of 287 individuals with repaired OFCs. Raw measurements were converted to sex and age-normalized Z-scores. Mean Z-scores for individuals with cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP) were compared with reference normative values (controls) and one another directly using t tests and analysis of variance. RESULTS The CLP group showed a significant increase in intercanthal width (P = .001) and intercanthal index (P < .001) compared with reference norms. The CP group showed a significant decrease (P < .001) in outercanthal width. The CL group showed no difference from reference norms. The proportion of clinically hyperteloric individuals was generally low but highest in the CLP group (7.4%). Cleft severity had little effect on interorbital spacing. CONCLUSIONS Individuals with CLP exhibited on average a tendency toward mild hypertelorism, driven primarily by an increase in intercanthal distance. This tendency was not seen in CL or CP.
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21
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Ullah A, Kalsoom UE, Umair M, John P, Ansar M, Basit S, Ahmad W. Exome sequencing revealed a novel splice site variant in the ALX1 gene underlying frontonasal dysplasia. Clin Genet 2016; 91:494-498. [PMID: 27324866 DOI: 10.1111/cge.12822] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 06/11/2016] [Accepted: 06/13/2016] [Indexed: 12/19/2022]
Abstract
Frontonasal dysplasia (FND) is a heterogeneous group of disorders characterized by hypertelorism, telecanthus, broad nasal root, wide prominent nasal bridge, short and wide nasal ridge, broad columella and smooth philtrum. To date one X-linked and three autosomal recessive forms of FND have been reported in different ethnic groups. We sought to identify the gene responsible for FND in a consanguineous Pakistani family segregating the disorder in autosomal recessive pattern. Genome-wide homozygosity mapping using 250KNsp array revealed five homozygous regions in the selected affected individuals. Exome sequencing found a novel splice acceptor site variant (c.661-1G>C: NM_006982.2) in ALX1. Sanger sequencing confirmed the correct segregation of the pathogenic variant in the whole family. Our study concludes that the splice site variant identified in the ALX1 gene causes mild form of FND.
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Affiliation(s)
- A Ullah
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - U-E Kalsoom
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - M Umair
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - P John
- Department of Healthcare Biotechnology, Atta-ur-Rehman School of Applied Biosciences (ASAB), National University of Science & Technology (NUST), Islamabad, Pakistan
| | - M Ansar
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - S Basit
- Center for Genetics and Inherited Diseases, Taibah University, Al Madinah Al Munawarah, Saudi Arabia
| | - W Ahmad
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
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22
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Gupta S, Fahiminiya S, Wang T, Dempsey Nunez L, Rosenblatt DS, Gibson WT, Gilfix B, Bergeron JJM, Jerome-Majewska LA. Somatic overgrowth associated with homozygous mutations in both MAN1B1 and SEC23A. Cold Spring Harb Mol Case Stud 2016; 2:a000737. [PMID: 27148587 PMCID: PMC4853519 DOI: 10.1101/mcs.a000737] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Using whole-exome sequencing, we identified homozygous mutations in two unlinked genes, SEC23A c.1200G>C (p.M400I) and MAN1B1 c.1000C>T (p.R334C), associated with congenital birth defects in two patients from a consanguineous family. Patients presented with carbohydrate-deficient transferrin, tall stature, obesity, macrocephaly, and maloccluded teeth. The parents were healthy heterozygous carriers for both mutations and an unaffected sibling with tall stature carried the heterozygous mutation in SEC23A only. Mutations in SEC23A are responsible for craniolenticosultura dysplasia (CLSD). CLSD patients are short, have late-closing fontanels, and have reduced procollagen (pro-COL1A1) secretion because of abnormal pro-COL1A1 retention in the endoplasmic reticulum (ER). The mutation we identified in MAN1B1 was previously associated with reduced MAN1B1 protein and congenital disorders of glycosylation (CDG). CDG patients are also short, are obese, and have abnormal glycan remodeling. Molecular analysis of fibroblasts from the family revealed normal levels of SEC23A in all cells and reduced levels of MAN1B1 in cells with heterozygous or homozygous mutations in SEC23A and MAN1B1. Secretion of pro-COL1A1 was increased in fibroblasts from the siblings and patients, and pro-COL1A1 was retained in Golgi of heterozygous and homozygous mutant cells, although intracellular pro-COL1A1 was increased in patient fibroblasts only. We postulate that increased pro-COL1A1 secretion is responsible for tall stature in these patients and an unaffected sibling, and not previously discovered in patients with mutations in either SEC23A or MAN1B1. The patients in this study share biochemical and cellular characteristics consistent with mutations in MAN1B1 and SEC23A, indicating a digenic disease.
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Affiliation(s)
- Swati Gupta
- Department of Human Genetics, McGill University, Montreal, Quebec H3A 1B1, Canada
| | - Somayyeh Fahiminiya
- Department of Human Genetics, McGill University, Montreal, Quebec H3A 1B1, Canada
| | - Tracy Wang
- Department of Human Genetics, McGill University, Montreal, Quebec H3A 1B1, Canada
| | - Laura Dempsey Nunez
- Department of Human Genetics, McGill University, Montreal, Quebec H3A 1B1, Canada
| | - David S Rosenblatt
- Department of Human Genetics, McGill University, Montreal, Quebec H3A 1B1, Canada;; Department of Pediatrics, McGill University, Montreal, Quebec H4A 3J1, Canada
| | - William T Gibson
- Department of Medical Genetics, Child and Family Research Institute, Vancouver, British Columbia V6H 3V4, Canada
| | - Brian Gilfix
- Department of Medicine, McGill University, Montreal, Quebec H4A 3J1, Canada
| | - John J M Bergeron
- Department of Medicine, McGill University, Montreal, Quebec H4A 3J1, Canada
| | - Loydie A Jerome-Majewska
- Department of Human Genetics, McGill University, Montreal, Quebec H3A 1B1, Canada;; Department of Pediatrics, McGill University, Montreal, Quebec H4A 3J1, Canada;; Department of Anatomy and Cell Biology, McGill University, Montreal, Quebec H3A 0C7, Canada
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23
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Hufnagel RB, Zimmerman SL, Krueger LA, Bender PL, Ahmed ZM, Saal HM. A new frontonasal dysplasia syndrome associated with deletion of the SIX2 gene. Am J Med Genet A 2015; 170A:487-491. [PMID: 26581443 DOI: 10.1002/ajmg.a.37441] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 09/17/2015] [Indexed: 11/06/2022]
Abstract
The frontonasal dysplasias are a group of craniofacial phenotypes characterized by hypertelorism, nasal clefting, frontal bossing, and abnormal hairline. These conditions are caused by recessive mutations in members of the aristaless gene family, resulting in abnormal cranial neural crest migration and differentiation. We report a family with a dominantly inherited craniofacial phenotype comprised of frontal bossing with high hairline, ptosis, hypertelorism, broad nasal tip, large anterior fontanelle, cranial base anomalies, and sagittal synostosis. Chromosomal microarray identified a heterozygous 108.3 kilobase deletion of chromosome 2p21 segregating with phenotype and limited to the sine oculis homeobox gene SIX2 and surrounding noncoding DNA. Similar to the human SIX2 deletion phenotype, one mouse model of frontonasal dysplasia, brachyrrhine, exhibits dominant inheritance and impaired cranial base chondrogenesis associated with reduced Six2 expression. We report the first human autosomal dominant frontonasal dysplasia syndrome associated with SIX2 deletion and with phenotypic similarities to murine models of Six2 Loss-of-function.
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Affiliation(s)
- Robert B Hufnagel
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics. University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Sarah L Zimmerman
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics. University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Laura A Krueger
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics. University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Patricia L Bender
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics. University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Zubair M Ahmed
- Department of Otorhinolaryngology, University of Maryland, Baltimore, Maryland
| | - Howard M Saal
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics. University of Cincinnati College of Medicine, Cincinnati, Ohio
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24
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Bhoj EJ, Li D, Harr MH, Tian L, Wang T, Zhao Y, Qiu H, Kim C, Hoffman JD, Hakonarson H, Zackai EH. Expanding the SPECC1L mutation phenotypic spectrum to include Teebi hypertelorism syndrome. Am J Med Genet A 2015; 167A:2497-502. [PMID: 26111080 DOI: 10.1002/ajmg.a.37217] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/08/2015] [Indexed: 12/30/2022]
Abstract
Teebi hypertelorism syndrome is a rare autosomal dominant disorder that has eluded a molecular etiology since first described in 1987. Here we report on two unrelated families with a Teebi hypertelorism-like syndrome and Teebi hypertelorism phenotype who have missense mutations in Sperm Antigen With Calponin Homology And Coiled-Coil Domains (SPECC1L), previously associated with oblique facial clefting and Opitz G/BBB syndrome. The first patient and his affected mother were previously-reported by Hoffman et al. in this journal as a new syndrome resembling Teebi hypertelorism and Aarskog syndromes in 2007. This patient had hypertelorism, sagittal and coronal craniosynostosis, ptosis, natal teeth, unusual umbilicus, shawl scrotum, small hands, and feet, with grossly normal development. Our second patient had classic Teebi hypertelorism syndrome with hypertelorism and a giant umbilical hernia. Patient one and his affected mother had a c.1260G>C:p.E420D variant and patient two had a de novo c.1198_1203delATACAC:p.I400_H401del variant in SPECC1L. We review the phenotypic findings in the previously-published Teebi hypertelorism syndrome patients, and the Opitz G/BBB patients with SPECC1L mutations. In addition we emphasize the findings of aortic root dilation and craniosynostosis in these patients, which should be considered in their management.
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Affiliation(s)
- Elizabeth J Bhoj
- Department of Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Dong Li
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Margaret H Harr
- Department of Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Lifeng Tian
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tiancheng Wang
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Yan Zhao
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Haijun Qiu
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Cecilia Kim
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jodi D Hoffman
- Division of Genetics, Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elaine H Zackai
- Department of Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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25
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Abstract
Gerard Guiot (1912-1998) was one of the most renowned and innovative neurosurgeons of the 20th century. His pivotal and revolutionary role in advancing transsphenoidal surgery has been recorded in many historical vignettes, yet his outstanding contributions to the advancement of neurosurgery outside the confines of the sella have not been described in a detailed fashion. In this article, the authors discuss the life and achievements of Professor Guiot and present a comprehensive description of his contributions to the field of neurosurgery, including cerebrovascular, spine, craniofacial, stereotactic functional, and endoscopic surgery.
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Affiliation(s)
- Khaled M Krisht
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah; and
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26
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Britto JA, Greig A, Abela C, Hearst D, Dunaway DJ, Evans RD. Frontofacial surgery in children and adolescents: techniques, indications, outcomes. Semin Plast Surg 2014; 28:121-9. [PMID: 25210505 DOI: 10.1055/s-0034-1384807] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The techniques of frontofacial surgery are most valuable in the clinical management of complex craniofacial deformity to achieve a range of functional and aesthetic gains in children from infancy to maturity. A variety of complex craniofacial osteotomies that can be used to separate the orbits from the skull base have been described. In addition, the combination of circumorbital release and pterygomaxillary disjunction allows advancement of the orbitomaxillary segment for powerful clinical benefit. For the purpose of this article, the principal frontofacial strategies include the monobloc frontofacial advancement by distraction (MBD), frontofacial bipartition advancement by distraction (BpD), orbital box osteotomy (FFBx), and frontofacial bipartition (FFBp). These techniques are broadly used for two purposes: to allow for the translocation of one or both orbits to correct orbitofacial disproportion (hypertelorism, vertical orbital dystopia, or a combination of both), or to advance the orbitomaxillary segment for orbital volume expansion and protection of the eye in syndromes featuring severe exorbitism (oculo-orbital disproportion). Here we describe aspects of our experience of frontofacial surgery in the Craniofacial Centre at Great Ormond Street Hospital for Children, London, with reference to the principles underpinning frontofacial surgical techniques, their challenges, and their impact on function and aesthetics.
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Affiliation(s)
- J A Britto
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - A Greig
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - C Abela
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - D Hearst
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - D J Dunaway
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - R D Evans
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
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27
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Isidor B, Lefebvre T, Le Vaillant C, Caillaud G, Faivre L, Jossic F, Joubert M, Winer N, Le Caignec C, Borck G, Pelet A, Amiel J, Toutain A, Ronce N, Raynaud M, Verloes A, David A. Blepharophimosis, short humeri, developmental delay and hirschsprung disease: expanding the phenotypic spectrum of MED12 mutations. Am J Med Genet A 2014; 164A:1821-5. [PMID: 24715367 DOI: 10.1002/ajmg.a.36539] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 02/23/2014] [Indexed: 12/27/2022]
Abstract
We report on two male sibs, a fetus and a newborn, with short humeri and dysmorphic facial features including blepharophimosis. The newborn also had Hirschsprung disease. Goldberg-Shprintzen syndrome and the Say-Barber-Biesecker-Young-Simpson type of Ohdo syndrome were suspected but direct sequencing of KBP and KAT6B failed to identify a mutation. Finally, direct sequencing of MED12, the gene mutated in Opitz-Kaveggia syndrome, Lujan-Fryns syndrome and X-linked Ohdo syndrome identified in the two sibs the missense mutation c.3443G>A (p.Arg1148His) inherited from the mother. This report further expands the phenotypic spectrum of MED12 mutations.
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Affiliation(s)
- Bertrand Isidor
- Service de Génétique Médicale, CHU de Nantes, Nantes, France; INSERM, UMR-S 957, Nantes, France
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28
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Abstract
Loeys-Dietz syndrome is characterised by vascular aneurysms, hypertelorism, and a bifid uvula. We report on an 11-year-old boy with Loeys-Dietz syndrome who presented with bilateral radial head dislocations and severe osteopaenia with changes of avascular necrosis in both hips causing an out-toeing, wide gait. Considering the poor prognosis for elbow movement and possible radial head dysplasia, surgical reduction of the radial heads was deferred. A subtrochanteric de-rotation osteotomy of the left hip was performed to improve the gait.
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Affiliation(s)
- Tarush Rustagi
- Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, Maharashtra, India
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29
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Abstract
Orbital hypertelorism is a craniofacial abnormality that arises on its own or as part of a number of syndromes. It is not uncommon to find the condition in association with maxillary hypoplasia. This manuscript reports an uncommon case of Tessier 2, 12 with orbital hypertelorism and dentoskeletal maxillary prognathism. To correct the condition, the first stage procedure was a modification of facial bipartition, according to the need of the case, followed by correction of alar cleft by Denonvilliers technique.
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Affiliation(s)
- S M Balaji
- Balaji Dental and Craniofacial Hospital, 30, KB Dasan Road, Teynampet, Chennai, Tamil Nadu, India
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30
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Abstract
This is a report of a rare case of frontonasal dysplasia (FND) in a full-term girl with birth weight of 2.750 kg. The baby had the classical features of FND. There were no other associated anomalies. There was no history of consanguinity and no family history of similar conditions. So inheritance of this case could be considered sporadic. Maxillofacial surgery should be considered for all patients for whom improvement is possible. However, in developing countries where there are considerable limitations in provision of social services, with economic and educational constraints, correction of such major defects remains a challenging task.
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Affiliation(s)
- Seema Sharma
- Department of Paediatrics, Dr. Rajendra Prasad Govt. Medical College and Hospital, Kangra (Tanda), Himachal Pradesh, India
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31
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Abstract
Dandy–Walker malformation (DWM) is a rare intracranial congenital abnormality that affects the cerebellum and some of its components; particularly cerebellar vermis, fourth ventricle and is characterized by an enlarged posterior fossa. Although there is an extensive list of signs attributed to DWM, final diagnosis is solely dependent on imaging techniques as there are no signs that are characteristic of DWM. This article reports a case with DWM who was diagnosed by magnetic resonance imaging.
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Affiliation(s)
- Jyothi Tadakamadla
- Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Udaipur-313 001, Rajasthan, India
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32
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Abstract
We report on 2 patients (3 1/2 year-old-male and 6-year-old female) with the ring 15 chromosome syndrome and speech delays and review 25 cases from the literature. The main characteristics of this syndrome include growth retardation (100%), variable mental retardation (95%), microcephaly (88%), hypertelorism (46%), and triangular facies (42%). Other frequent findings include delayed bone age (75%), brachydactyly (44%), speech delay (39%), frontal bossing (36%), anomalous ears (30%), café-au-lait spots (30%), cryptorchidism (30%), and cardiac abnormalities (30%). The average age at diagnosis was 8.1 years. The average maternal and paternal age at the time of birth was 28 and 31 years, respectively.
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Affiliation(s)
- M G Butler
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232
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